Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02569 | Date 20/07/2019 |
| Token No | SM/18-19/5022 20/07/2019 | Serial | 032 |
| Patient Name | Mr. MADAN HELA | Contact No | 7003282065 |
| Address | BAT TALA | Age | 70 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||